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Year 4 - Paeds > Congenital Heart Defects > Flashcards

Congenital Heart Defects Flashcards

1
Q

Patent Ductus Arteriosus
- Risk Factors

A

PDA RFs

  1. Prematurity (29 weeks)
  2. RDS
  3. Mechanical ventilation
  4. Infection
  5. Lack of antenatal steroid treatment
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2
Q

Patent DA
- Sequallae

  1. Pulmonary
  2. Systemic
A

PDA
- Sequallae

  1. Left to right shunt
  2. Increased pulmonary blood flow
    - Respiratory distress
    - Ventilator dependance
    - Acidosis
    - Pulmonary hemorrhage
    - Chronic lung disease
  3. Reduced systemic flow
    - Hypotension
    - Ischaemia (cerebral/mesenteric)
    - Necrotising enterocolitis
    - Intraventricular haemorrhage
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3
Q

CHD
- Physiological Fetal shunts

A

Fetal shunts

  1. Ductus arteriosus
  2. Ductus venosum
  3. Foramen ovale
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4
Q

CHD
- Genetic associations

A

CHD associations

  1. T21, T18, T13, 45 X0
  2. DiGeorge, CHILD syndrome
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5
Q

CHILD Syndrome
- Features

A

CHILD Syndrome

  1. Congenital hemidysplasia
  2. Ichthyosiform erythroderma
  3. Limb defects
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6
Q

ASD (cardiac)

  1. S&S
  2. Ix
  3. Mx
A

ASD

  • S&S
    1. Recurrent chest infections
    2. Systolic (/mid-diastolic) murmur
  • Ix
    1. ECG: RBBB
    2. ECHO: Dilated RV
  • Secundum region defect
  • Mx
    1. Transcatheter closure
    2. Surger
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7
Q

VSD

  1. S&S
  2. Mx
A

VSD

  • S&S
    1. SoB/Tach p/c
    2. Failure to thrive
    3. Tired even when eating
  • Mx
    1. Self-resolving
    2. Diuretics/ACEi/Calories
    3. RSV Vaccination
    4. <10% surgery
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8
Q

PDA

  1. Pres ( Pre-, Peri-, Post-)
  2. Mx
A

PDA

  • Pres
    1. 20 weeks antenatal scan
    2. NIPE
    3. Murmur

Mx
1. Transcatheter occlusion
2. Coil embolisation

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9
Q

AVSD

  1. Types
  2. S&S
A

AVSD

  • Types
    1. Partial
  • ASD and Single valve
    2. Transitional
    3. Complete
  • ASD, VSD, single valve
  • S&S
    1. Dependant upon size/position
  • ASD
  • VSD
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10
Q

Aortic stenosis

  1. Presentation
  2. ECG
  3. Mx
A

Aortic Stenosis

  • Presentation
    1. Age variable
  • Baby very sick
  • Child with murmur
  • Older child with collapse
    2. Ejection click
    3. 45 X0
  • ECG
    1. T inversion
    2. LAD
    3. Tall precordial leads (Strain)
  • Mx
    1. Monitor
    2. Advise re: endocarditis
    3. Balloon/open surgery
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11
Q

Co-arction

  1. Epidemiology
  2. Mx
A

Co-arction

  • Pres
    1. 10% of CHD
    2. Neonate/teen
  • Mx
    1. Neonate -surgery
    2. Teen - balloon
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12
Q

Pulmonary Stenosis

  1. Pres
  2. Mx
A

Pulmonary stenosis

  • Pres
    1. Noonan syndrome
  • Mx
    1. Balloon
  • If not supravalvular
    2. Surgery
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13
Q

Cyanotic heart defects
- 5Ts + S

A

Cyanotic heart defects

  1. Tetralogy of Fallot
  2. Transposition of great arteries
  3. Tricuspid anomaly
    - Ebstein’s
  4. TAPVR
    - Total anomalous pulmonary venous return
  5. Truncus arteriosus
  6. Single ventricle
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14
Q

Tetralogy of Fallot

  1. Features
  2. Pres
  3. Mx
A

Tetralogy of fallot

  • Features
    1. VSD
    2. Overriding aorta
    3. Small PA
    4. RVH
  • Pres
    1. Loud systolic murmur
    2. Single S2
    3. RAD on ECG

Mx
1. PG1
2. Inotropes
3. Surgery

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15
Q

Cyanotic spell
1. Aetiology
2. Mx

A

Cyanotic spell

  1. Outflow obstruction
    - Common in CHDs
  2. Mx
    - Flex hips
    - Cut of femorals
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16
Q

Transposition of GAs

  1. Pres
  2. Mx
A

Transposition of GAs

  • Pres
    1. Antenatal scan
  • Parallel arteries
    2. NIPE
    3. Cyanosis D1-2

Mx
1. Balloon septostomy
2. Arterial switch op

17
Q

Tricuspid anomaly

  1. Sequelae
  2. S&S
A

Tricuspid anomaly (Ebstein’s)

Sequelae
1. Displaced tricuspid
2. Small RV
3. Atrialised RV

  • S&S
    1. Cyanosis
    2. Extreme RH failure
    3. Adult arhythmia
18
Q

TAPVR

  1. Pathology
  2. Obstructed
    - Pres
    - Mx
  3. Unobstructed
    - Pres
    - Mx
A

Total anomalous pulmonary venous return

  1. Pathology
    - Pulmonary veins return to RA not LA
    - ASD must be present
  • Obstructed
    1. Neonate presentation
  • Pulmonary HTN
    2. Emergency surgery
  • Unobstructed
    1. Infant presentation
  • Chest infections
  • Low sats
  • Murmur
    2. Surgery
19
Q

Truncus arteriosus

  1. Pres
  2. Mx
A

Truncus arteriosus
- Common arterial trunk

Pres
1. Cyanosis after a few weeks
2. Mixed Ao and PA

Mx
1. Surgery

20
Q

Single Ventricle Defect

  1. Pres
  2. Mx
A

Univentricular heart

  • Pres
    1. 5/100,000
    2. Antenatal Dx
  • Mx
    1. Palliation
    2. Surgery
  • Norwood operation
  • Glenn’s Surgery
  • FONTAN Total CPC operation

Year 4 - Paeds (11 decks)

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